HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE'02/05/2010 19:21
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Date: v�-'Cs.l
772229943 I a
Plann6ng & Development Services
Buildi g &. Code Regulation Division
2300 . irgilnia Ave
Fort p�Iierce, FL 34982
772-�!62-2165 Fax 772-462-6443
Request for 30-
Project Address: abLm f `�
Temporary Power Release
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THE UNDERSIGNED HEREBY REQUEST REL SE OF ELECTRICAL, POWER TO THE ABOVE DESCRIBED.
PROPERTY, FOR A PERIOD NOT TO EX("EED RTY (30) DAYS, FOR THE PURPOSE OF TESTING SYSTEMS
AND EQUIPMENT IN PREPARATION FOR A FIJHI
IAL INSPECTION. IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE HEREBY ACKNOWLEDGE AND AGREE AS FOLLOWS:
1. This temporary power release is requ+
occupancy of any type, other than the
2. As witness by our signatures, we here
including Building Division Policy, whit
3. All conditions and requirements listed
Power for Testing" have been fulfilled
4. All requests for an extension beyond
the reason for the request. Power ml
the Final Inspection has not been app
the Stop Work Order.
ted for the above stated purpose only, and there will be no
permitted by construction during this time period.
, agree to abide by all terms and conditions of this agreement,
Is incorporated herein by reference.
i the attached document entitled "Requirements for 30 Day
nd the premise Is ready for compliance inspection.
days must be made in writing to the Building Official stating
be removed from the site and/or a Stop Work Order issued if
wed within 30 days. A fee of $100.00 will be required to lift
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS, ST. LUCIE COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILITIES AND CLAIMS OF ANY TYPE 00 NATURE WHICH MAY ARISE NOW OR IN THE FUTURE OUT
OF THIS T�RAT ON, INCLUDING ANY DAMAGE WHICH MAY BE INCURRED DUE TO THE
DISCONN O 0,aRIdk1,P0WER IN THE EVEN' OF VIOLATION OF THIS AGREEMENT.
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OWNER IGNAT RE DATE
GENERAL CONTRACTO SIGN A RE ' DATE
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ELECT CONTRACTOR SIGNA I DATE